Compliance Resources

Medicare & Medicaid

Official CMS references for program requirements, coverage, claims, education, and integrity oversight.

Reference standard: Confirm the current effective date and applicability of each source before relying on it for an audit finding, coding decision, provider education, or compliance determination.

Medicare Learning Network

CMS education for healthcare providers on Medicare policies, coding, billing, and program requirements.

  • Publications and multimedia
  • Web-based training
  • MLN Matters articles
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Medicare Provider Compliance Tips

Practical CMS guidance on common billing, coding, and documentation issues.

  • Provider-specific tips
  • Compliance reminders
  • Billing guidance
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CMS Internet-Only Manuals

Official Medicare manuals governing benefit policy, claims processing, program integrity, enrollment, and other operations.

  • Claims Processing Manual
  • Program Integrity Manual
  • Benefit Policy Manual
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Medicaid.gov

Federal Medicaid and CHIP policy, program, eligibility, quality, and state-resource information.

  • Federal policy guidance
  • State resources
  • Program integrity
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Medicare Coverage Database

Official CMS database for Medicare national and local coverage requirements.

  • NCDs
  • LCDs
  • Coverage articles
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